TO COMFORT ALWAYS. An inter-cultural spiritual care directory for use by front line service providers

Transcription

1 (Registered Charity No ) TO COMFORT ALWAYS An inter-cultural spiritual care directory for use by front line service providers The title of this Directory is taken from a 15 th century French proverb, To heal sometimes, to comfort always, quoted by Oliver Wendell Holmes. 1

2 CONTENTS Foreword 3 THE NHS Constitution 4 Introduction 5-6 THE BAHÁ Í PATIENT 7-8 THE BUDDHIST PATIENT 9-10 THE CHINESE PATIENT: CHINESE RELIGIONS AND CUSTOMS THE CHRISTIAN PATIENT: ANGLICAN THE CHRISTIAN PATIENT: ORTHODOX THE CHRISTIAN PATIENT: ROMAN CATHOLIC THE CHRISTIAN PATIENT: FREE CHURCH THE CHRISTIAN SCIENTIST PATIENT 21 GYPSIES AND TRAVELLERS: CULTURE AND RELIGIOUS AFFILIATIONS THE HINDU PATIENT THE HUMANIST PATIENT 26 THE JAIN PATIENT 27 THE JEHOVAH S WITNESS PATIENT 28 THE JEWISH PATIENT THE MORMON PATIENT 31 THE MUSLIM PATIENT THE PAGAN PATIENT 34 PATIENTS WHO HAVE NO RELIGIOUS ALLEGIANCE / ATHEIST AND AGNOSTIC PATIENT 35 THE PLYMOUTH BRETHREN PATIENT 36 THE RASTAFARIAN PATIENT 37 THE RELIGIOUS SOCIETY OF FRIENDS (QUAKERS) 38 THE SEVENTH-DAY ADVENTIST PATIENT THE SIKH PATIENT 41 THE SPIRITUALIST PATIENT 42 THE UNITARIAN PATIENT 43 THE ZOROASTRIAN PATIENT 44 APPENDICES ONE AND TWO: POST MORTEMS; PUBLICATIONS 45-46/47 APPENDICES THREE AND FOUR: NAMES; USEFUL PHONE NUMBERS 48/

3 Foreword To Comfort Always has been prepared in response to a review undertaken by the Redbridge End of Life Care Scrutiny Working Group in March The findings of the review and a series of recommendations were presented in a report to Cabinet in September The review subsequently went on to win the Involving Communities category at the Centre for Public Scrutiny (CfPS) Awards in 2012, in recognition of the high level of community engagement during the review and the work undertaken by John Powell the Director of Social Services and Housing, to implement the recommendations. The Scrutiny Working Group report included a list of 15 evidence-based recommendations, written using contributions from a range of people including carers, representatives from the council and NHS, for example social work practitioners, palliative care specialist nurses, voluntary sector and faith group representatives and members of the public. It recognised that death is a taboo subject and many people do not wish to talk about how they would like to be cared for at the end of life. This can mean that friends, relatives and professionals providing care are not aware of their wishes. So it is important that people are encouraged to talk about their wishes and to plan for their end of life. The recommendations aimed to strengthen joint working, promote good quality end of life care in all care settings, through improved education and training in end of life issues and to promote awareness of choice and the importance of planning for future care and support based on need rather than diagnosis. The values expressed reflect those which are incorporated in the NHS Constitution over the page. The report quotes Dame Cicely Saunders founder of the modern hospice movement: You matter because you are you and you matter to the end of your life. We will do all we can not only to help you die peacefully, but also to live until you die The most relevant recommendations guiding the production of To Comfort Always were:- We recommend that end of life care providers should work in partnership with and engage local communities in order to raise the profile of end of life care and promote awareness of the importance of being open to talking about death and planning end of life care; and We recommend that a guidance document on end of life care for all faith groups and diverse multi cultural backgrounds be developed, in liaison with faith groups and other relevant groups and made available to all involved in providing end of life care We would welcome any comments, additions or amendments to this document including any additional contacts for local Faith Groups. Please contact: Julie Fanning Executive Policy Adviser /Adult Social Services Ley Street House, 497 Ley Street, Ilford, Essex, IG2 7QX Tel: julie.fanning@redbridge.gov.uk Acknowledgements A version of this directory was first published by the Oakhill Trust, a charity set up to encourage the development of spiritual care in the Health Service, in conjunction with Bromley Hospitals NHS Trust. We gratefully acknowledge that Dr Hillary Hones from the Oakhill Trust agreed that we could use their original document as a model for a Redbridge Directory 3

4 THE NHS CONSTITUTION The NHS belongs to us all It is there to improve our health and well-being, supporting us to keep mentally and physically well, to get better when we are ill and, when we cannot fully recover, to stay as well as we can to the end of our lives. It works at the limits of science bringing the highest levels of human knowledge and skill to save lives and improve health. It touches our lives at times of basic human need, when care and compassion are what matter most. The NHS is founded on a common set of principles and values that bind together the communities and people it serves patients and public and the staff who work for it. Seven key principles guide the NHS in all it does:- 1. The NHS provides a comprehensive service, available to all irrespective of gender, race, disability, age, sexual orientation, religion or belief. It has a duty to each and every individual that it serves and must respect their human rights. At the same time, it has a wider social duty to promote equality through the services it provides and to pay particular attention to groups or sections of society where improvements in health and life expectancy are not keeping pace with the rest of the population. 2. Access to NHS services is based on clinical need, not an individual s ability to pay. 3. The NHS aspires to the highest standards of excellence and professionalism. 4. NHS services must reflect the needs and preferences of patients, their families and their carers. Patients, with their families and carers, where appropriate, will be involved in and consulted on all decisions about their care and treatment. 5. The NHS works across organisational boundaries and in partnership with other organisations in the interest of patients, local communities and the wider population. The NHS is an integrated system of organisations and services bound together by the principles and values now reflected in the Constitution. The NHS is committed to working jointly with local authorities and a wide range of other private, public and third sector organisations at national and local level to provide and deliver improvements in health and well-being. 6. The NHS is committed to providing best value for taxpayers money and the most effective, fair and sustainable use of finite resources. 7. The NHS is accountable to the public, communities and patients that it serves. These principles are underpinned by core NHS values which have been derived from extensive discussions with staff, patients and the public. 4

5 INTRODUCTION Everyone will have spiritual as well as physical and psychological needs. It is hoped that this Directory will help you to maintain a holistic approach to the people in your care. Spirituality has been variously defined, for example, as that inner space that relentlessly seeks meaning in oneself, in others and in the universe 1 ; another description says Spirituality allows me to reflect on myself. I am a person because of my spirituality motivated and enabled to value, to worship and to communicate with the holy, the transcendent. 2 Whatever their faith or belief system, a person s concern for well-being in his/her personal journey is important. Many will have found meaning in a tradition or religion and will want to be able to practise rituals of their faith at home, in hospital or nursing home. Others will have different beliefs. It is important to enable the individual s experience to be understood in terms of faith and belief. 3 The crisis of illness may stimulate a search for spiritual meaning, or may spark off questions and doubts about previously held beliefs. It is important that health and social care workers are aware of this and are equipped to help anyone who is facing the need to make sense of their lives and to find a way to respond to suffering. It has been shown that there is a relationship between attention to spiritual needs and improved recovery from illness or ability to cope with pain. 4 5 Good communication, attention and 'being there' for the patient is 50% of the cure. If care of the mind and body is not integrated, it is more difficult for the body to recover. 6 Britain has always had a multicultural dimension. The 2001 census identified that approximately 14% of the population belong to Black, Asian and minority ethnic communities. Their cultures and faiths need to be understood as far as possible, and always appreciated and respected. Members of some societies in Europe may have a dual perspective, separating religion and culture from health, but this is often not the case in some other societies. There is a wide spectrum of culture and belief and no individual should be stereotyped. Many members of faith communities are not orthodox in all their beliefs or practices. There are many stresses which disadvantage people: social disadvantage, loss of social support, psycho-social factors such as prejudice and stereotyping, and language difficulties. Different cultures show emotional distress in different ways, and behaviour which might appear abnormal to others might not do so to the individual concerned and their cultural group. Some communities may use traditional remedies and put great reliance on alternative medicines or practices of their faith; health and social care practitioners with duty of care, should be aware of this. All these factors need to be taken into account. 7 Of course, in supporting people s beliefs, no action which is contrary to English law should be undertaken. The Borough of Redbridge is experiencing many demographic changes, including: population growth, changing age structures, and increased international migration. The population of Redbridge was estimated to be 267,700 in mid Redbridge is the 9 th largest borough in London and is projected to grow to more than 300,000 people by The population has grown by 12.2% since the 2001 Census, the 5 th highest in London Redbridge is an increasingly young Borough. The average of residents (37 years) is slightly lower than in England and Wales, while the number of children under the age of 16 (21.5%) ranks the Borough as the 29 th youngest of 406 in Great Britain. There are about 71,000 (26.6%) children aged 0 19 in Redbridge, mainly living in the south of the Borough. The number of pupils is projected to continue to increase in Redbridge schools. Redbridge also has a growing older population (65+), currently estimated to be 33,000 people. For more details refer to the Council website Redbridge I or search for Redbridge Joint Strategic Needs Assessment. Faith is important to the people of Redbridge. There are over 130 places of worship and 77.5% of residents say they have a faith. There is strong respect and understanding between the different faiths, a crucial fact in an area with both large Muslim and large Jewish populations. 1 O Murchu, D. Reframing Religious Life. St Paul s, Slough, UK. 1995, p Stoll, R. The essence of spirituality in Spiritual dimensions of nursing practice, ed. V. Carson. W B Saunders, Philadelphia pp Health Care Chaplaincy Standards, Hospital Chaplaincies Council, Bristol, Hayward, J. Information a prescription against pain. (Study of Nursing Care, series 2 no. 8) Royal College of Nursing, London Keighly, T. Organisational structures and personal spiritual belief in International Journal of Palliative Nursing. Vol 3 no. 1 Jan Feb p Firth, S. "Counselling model: creating a healing environment in hospital" in Patient Education and Counselling 36 (1999) p87. 7 Main source of information for this paragraph: Julia Head, Chaplaincy Team, Maudsley Hospital. 5

6 In this Directory you will find details of different faiths or belief systems which you may meet, and it is hoped that this will help in the understanding and support of the patient or service user. But it is most important to remember that everyone is an individual and will have his/her own interpretations, practices, concerns and maybe doubts. So here are some general suggestions on how to support people: Be ready and willing to listen. Ask if there are any particular needs. Ask how the patient wishes to be addressed. This may vary by age and culture. Using only their given name might be disrespectful in some cultures. (There is a separate note about names in Appendix Three) Enquire about diet. In hospital, special diets can usually be provided. If the patient wishes to fast, check that this is compatible with their condition. Show respect for the patient's beliefs. Ensure as much privacy as possible for religious observances, by drawing the curtains around the bed or using a quiet room or chapel if possible. In the community, please establish contact with the person s nearest place of worship, if they request this, to enable support there or at home. Please ask if the patient would like a visit from a representative of their faith, and record the request to assist other staff. Contacts given in the directory will assist in the process, but no information about a patient should be given to these contacts without permission of the patient or next of kin. Be confident in your own beliefs and draw upon the spiritual resources of your own faith or belief; but only share your views if asked to do so. Please be alert to people s feelings, hopes and aims. Seek advice and support in responding to your encounters. Have a colleague with whom you can discuss problems in confidence. The customs and practices of the various communities that this directory describes are those most generally found. However within many communities there are variations and customs and practices often develop or change with the passage of time. Therefore this directory is a guide only and although every effort has been made to be accurate it does not purport to be authoritative. If you have any comments please let us have them. 6

7 THE BAHÁ Í PATIENT DIET The information below is a general guide only. Always check everything with the patient/client. If in doubt, ask them, or the contact, for advice. The Baha i Faith does not support any form of euthanasia. Baha is can have blood transfusions if it is deemed necessary. Prayer is an important part of a Baha i s everyday life. Baha i patients will often wish to have family/friends at the bedside, saying and reading prayers during a period of illness. Families may, if death is imminent, request to keep a 24 hr vigil at the bedside rather than keep normal visiting hours. After death has occurred prayers will often be read at the bedside. There are no clergy in the Baha i Faith so it is not relevant to try to contact a minister. Baha is should not be embalmed before burial. The body should be washed and wrapped in a cotton or silk shroud before burial. Cremation is not allowed in the Baha i Faith. Special fasting from 2 nd to 21 st March. Those who are ill are exempt from this requirement. Other Holy days: 21 st April, 29 th April, 2 nd May, 23 rd May, 29 th May, 9 th July, 20 th October, and 12 th November. It would be appreciated if these dates could be avoided when arranging appointments. The day starts at sunset the day before the above. There are obligatory daily prayers. Privacy is preferable for these. The hands and face are washed before prayer: an ordinary wash basin or bowl can be used. If possible, the patient should stand facing the shrine of Bahá ulláh, at Acre in Israel, in a south easterly direction from UK. (Please be ready to indicate this if requested). 1) There are no special dietary requirements or laws. However, Baha is do not drink alcohol, so any food prepared with alcohol would not be appropriate. 2) The patient may wish to fast; therefore food should be available before dawn and after dusk. CARE OF THE DYING 1) Death is seen as a transition to a further stage of life (like birth). 2) Patients may wish for members from the Spiritual Assembly of Baha i to come and pray with them. This may be arranged by the family. Privacy will be required for this. 3) Treat the body with great respect 4) Routine Last Offices and the body to be washed and wrapped in plain cotton or silk. 5) A special ring will be placed on the finger of the patient; this is not to be removed. 6) There are no Baha i ceremonies or special arrangements attached to regarding care of the dying. If the patient does not appear to have any family please contact the local Baha i community who will arrange for visitors. Prayer is an integral part of Baha i life and both the patient and visitors will read and sometimes chant aloud prayers for healing and spiritual progress. POST-MORTEMS AND ORGAN DONATION/TRANSPLANT 1) The Baha'i Faith considers organ and tissue donation a noble thing to do. However, provisions must be made to treat the donor's body with dignity and the remains must be buried within one hour's travel from the place of death. The decision to be a recipient of organ or tissue donation is left up to the individual, in consultation with a competent physician. If a post-mortem is deemed necessary the body should be treated with respect and returned to the family for burial. 7

8 The Baha i Patient: continued from previous page The Bahá'í Patient is continued overleaf CONTACT No information about a patient should be passed to these contacts without the permission of the patient or the next of kin. There are no clergy and community affairs are in the hands of Spiritual Assemblies, members of which will visit to comfort and pray. For the Redbridge Baha i Community Contact: Mrs C Khorsandyon bckh19@yahoo.co.uk For the National UK Baha i Office Contact:

9 The Buddhist Patient: continued from previous page THE BUDDHIST PATIENT DIET The information below is a general guide only. Always check everything with the patient/client. If in doubt, ask them, or the contact, for advice. There are many different Buddhist traditions, for example: Theravada and Mahayana (Tibetan, Zen, Pure Land, and some other Japanese groups) as well as the Western Buddhist order. Try to ascertain which tradition should be contacted, and find out which country the patient comes from. Peace and quiet for meditation and chanting would be appreciated; therefore access to a day room or a single room may be required. The offer of the Chapel for visiting Buddhists to pray in with the patient would be appreciated. The use of a side room would be valued. The need to wash hands before mediation. May wish to sleep on the floor. The image of a Buddha would bring comfort as will some flowers and an incense stick. These must be handled with great respect. Do not place any books or objects on top of their Spiritual Writings; their scriptures are to be treated with great respect. Many are vegetarians because of their respect for all life. CARE OF THE DYING 1) A side room is essential. The state of mind at death influences the character of rebirth. 2) Full information about their imminent death must be given to the patient to enable them 1) To make their own preparation for the event. An open, honest, and frank manner will be appreciated. 2) The need to approach death in a clear conscious state of mind is important; therefore this may mean the reduction of certain types of medication. 3) Patients should be fully involved and consulted at all stages of their treatment. 4) No special rituals after death but the relatives may appreciate support and comfort. 5) The need to inform a fellow Buddhist is important; the family may do this, if they are unavailable the Chaplain will fulfil this function, or staff may try the contact number themselves. 6) Cremation is preferred. The next of kin will advise. 7) Turning the mind of the patient to happy and buoyant thoughts will put him in the frame of mind required to make his journey to death. POST-MORTEMS AND ORGAN DONATION/TRANSPLANT 1) Unlikely for there to be any objections; however some Far Eastern Buddhists may object. 2) For post-mortems, normal legal procedures must be observed, and these should be explained to the next of kin. 3) For organ donation, the wishes of the patient and next The of Buddhist kin should Patient be is ascertained continued overleaf and consent obtained. 9

10 CONTACT No information about a patient should be passed to the contact without the permission of the patient or next of kin British Buddhist Association Buddhist Society (Non-sectarian) (Multi traditional) 11 Biddulph Road, 58 Eccleston Square Maida Vale London London SW1V 1PH W9 1JA Linh Son Buddhist Assoc in the UK 89 Bromley Road Catford London SE6 2UF Venerable Somarantha Thames Buddhist Vihara Dulverton Road Selsdon Surrey

11 THE CHINESE PATIENT: CHINESE RELIGIONS AND CUSTOMS We realise that this group is a different category form the others in this Directory, but feel it is valuable to give information about the Chinese culture. This page is under review and we would be grateful for suggestions. The information below is a general guide only. Always check everything with the patient/client. If in doubt, ask them, or the contact, for advice. There are many different Chinese dialects. Check that your interpreter speaks the same dialect as the patient. All Chinese dialects are written in the same script, but some older people may not be able to read and write, while some younger people may only read and write English. Chinese philosophy and way of life are based mainly on Confucianism and influenced by Buddhism and Taoism. Some Chinese are Christian, or from other faith or belief systems than those referred to already. Please refer to the relevant pages in this Directory The main values of the traditional way of life are obligations to family members, respect for elderly people, self-control and self-reliance. People may pray to their departed ancestors and many believe in reincarnation, but others do not. They may bring a picture or statue of their deity in to hospital, or may wear a pendant showing their deity which they may not wish to remove; these must be treated with respect. Traditional Chinese medicine is based on a principle of maintaining a natural balance within the body. The patient may wish to keep well wrapped up when feverish, and may feel they should not bath or shower when they are ill or have just had a baby. They should be asked what they would like to do. They may worry about the amount of blood which is taken for tests, as they fear it may harm their health. The reason and results of tests should be explained to them. Women as well as men traditionally wear trousers. They may find hospital gowns uncomfortable. Please see appendix two for "names". DIET 1) When ill or feverish, they like to avoid cold drinks and meals. Ask whether the patient would like a flask of hot water rather than a jug of cold water by their bed. 2) Patients may prefer a cup of hot water to a cup of tea in the morning. 3) They may regard rice as an essential source of nourishment. 4) Certain foods are regarded as beneficial or harmful, and the food should be balanced according to the principles of yin and yang. Therefore they may wish to have Chinese food if available, or may rely on their families to bring in food. 5) Many will bring their own chopsticks, or they may need a spoon and a bowl. The food will need to be in bite size pieces. The Chinese Patient is continued overleaf 11

12 The Chinese Patient: continued from previous page CARE OF THE DYING 1) Members of the immediate family will usually come and sit by the dying person. 2) For Christians or Buddhists, please see the relevant pages. Otherwise there are no special rites, but please refer to the family concerning the rites they wish to observe. 3) Some older people may regard death as bringing bad fortune, and may avoid a dying person and their family. 4) Some families may bring a special shroud to wrap the body in. 5) A traditional Chinese priest to conduct the burial may be difficult to find. Please refer to the family. POST-MORTEMS AND ORGAN DONATION/TRANSPLANT 1) Chinese people find post-mortems distressing, but normal legal procedures must be observed, and these should be explained to the next of kin. 2) For organ donation, the wishes of the patient and next of kin should be ascertained, and consent obtained. CONTACT Refer to the patient or family for advice. See Christian or Buddhist pages, if appropriate. 12

13 THE CHRISTIAN PATIENT ANGLICAN/CHURCH OF ENGLAND Church members are from a variety of cultural backgrounds, which affects their spirituality. The Anglican communion of churches includes: Church in Wales Episcopal Church in Scotland Church of England Episcopal Church in the USA Church of Ireland Churches with ecumenical agreements with the Anglican Church include some Lutheran Churches DIET The information below is a general guide only. Always check everything with the patient/client. If in doubt, ask them, or the contact, for advice. Patients usually wish to maintain their religious practice whilst receiving medical care; they may wish to pray for healing, receive anointing, read the Scriptures, and to consult with their own minister. They may wish to go to the Chapel or to a prayer room or quiet room, if available. Patients may wish to see a Chaplain before an operation for prayers and to receive Holy Communion. Remember that some Anglicans will admit the administration of a male priest only. Patients may request a Bible (The Gideon New Testament should be available at every bedside locker). Baptisms, Confirmations and Holy Communion may take place on the wards or in the hospital. These will be the Chaplain s responsibility. Marriages in hospital need special consent from managers and legal registration; they take place very occasionally; please refer to the Chaplain. If a patient is in any kind of spiritual distress, the local Vicar or, in hospital, the Chaplain may be called to offer comfort. 1) Some patients may wish to observe Friday as a no meat day, therefore a fish or vegetarian alternative must be made available. 2) Some patients may wish to fast before receiving Holy Communion, which may have implications for the serving of meals; fasting is not required of the very sick. 13

14 The Anglican Patient: continued from previous page CARE OF THE DYING 1) Prayers may be said at the bedside of the dying and sometimes it will be appropriate for the patient to be anointed. The close family must be asked. 2) After death the family may wish to gather around the bed to commend the person to God and to give thanks for their life. 3) Please ask the patient/significant others if they would like to see the Chaplain or wish their local priest to visit, in preparation for the patient s death and to respect the dying person s beliefs. 4) Blessing, Baptism or Commendation of infants who are seriously ill or in danger of death should be offered, with a referral to their own minister and/or to a chaplain. VIEWING THE BODY - VISITS TO SEE THOSE WHO HAVE DIED Please arrange the place/chapel of rest appropriately; a cross or crucifix may be placed in the chapel; commendatory prayers may be said. POST-MORTEMS AND ORGAN DONATION/TRANSPLANT 1) No religious objection to post-mortem examination: normal legal procedures must be observed, and these should be explained to the next of kin. 2) No religious objection to organ donation: the wishes of the patient and next of kin should be ascertained, and consent obtained. CONTACT No information about a patient should be passed to the contact without the permission of the patient or next of kin. The Chaplains of the NHS Trusts and Parish Priests. Any of the Mental Health Chaplains 14 The Christian Patient is continued overleaf for: Orthodox Churches, Roman Catholic, Free Church

15 THE CHRISTIAN PATIENT ORTHODOX and other Oriental Autocephalous Churches Church members are from a variety of cultural backgrounds, which affects their spirituality. The Orthodox Church includes several branches with their own patriarchs (senior bishops) or Archbishops. Orthodox Churches are numerically strong in Eastern Europe, the Mediterranean and the Middle East. In the United Kingdom communicant members of the church relate to the older, national, ethnic Churches. These include the Russian Orthodox, the Greek Orthodox, the Serbian Orthodox and the Oriental Orthodox Churches, such as the Armenian, Coptic, Ethiopian, Indian and Syrian Orthodox. DIET The information below is a general guide only. Always check everything with the patient/client. If in doubt ask them or the contact for advice. Patients usually wish to maintain their religious practice, whilst receiving medical care; they may wish to pray for healing, receive anointing, read the scriptures and to contact their own minister. They may wish to go to the chapel or to a prayer room or quiet room, if available. Patients may wish to see a Chaplain before an operation for prayers and to receive Holy Communion. Their own priest should be contacted if possible; otherwise refer to the Chaplain. Patients may request a Bible. (The Gideon New Testament should be available at every bedside locker). Baptism, Confirmation and Holy Communion may take place on the wards or in the Hospital Chapel. These will be the Chaplain s responsibility, with ministry arranged with the local Orthodox priest. Marriages in hospital need special consent from managers and legal registration and take place very occasionally; please refer to the Chaplain. If a patient is in any kind of spiritual distress, the Chaplain or an appropriate local minister may be called to offer comfort. The dates for Orthodox Christmas and Easter differ from the dates of the other main Christian traditions. 1) Some patients may wish to observe Friday as a no meat day, therefore a fish or vegetarian alternative must be made available 2) Some patients may wish to fast before receiving Holy Communion, which may have implications for serving meals. If patients are too ill to fast, this spiritual discipline is not required. 15

16 The Orthodox Patient: continued from previous page CARE OF THE DYING 1) In addition to the normal visits by the Chaplain, The Sacrament of the Sick with anointing is important. (This may also be required before an operation). 2) Inform the priest long before the point of death so that he may build up a relationship with the patient and the family at this stage of the patient s life. 3) The Orthodox priest should be contacted to care for a dying patient or one who has just died and he will normally be of assistance in consoling the relatives. 4) Baptism and Confirmation of infants in danger of death should take place. VIEWING THE BODY - VISITS TO SEE THOSE WHO HAVE DIED Please arrange the place/chapel of rest appropriately; a cross or crucifix may be placed in the chapel; commendatory prayers may be said. POST-MORTEMS AND ORGAN DONATION/TRANSPLANT 1) No religious objection to post-mortem examination: normal legal procedures must be observed, and these should be explained to the next of kin. 2) No religious objection to organ donation: the wishes of the patient and next of kin should be ascertained, and consent obtained. CONTACTS No information about a patient should be given to the contacts without the permission of the patient or next of kin. The Christian Patient is continued overleaf For Roman Catholic and Free Church 16

17 THE CHRISTIAN PATIENT ROMAN CATHOLIC The information below is a general guide only. Always check everything with the patient/client. If in doubt, ask them, or the contact, for advice. Patients usually wish to maintain their religious practice, whilst receiving medical care; they may wish to pray for healing, receive anointing, read the Scriptures, and make use of a Rosary and to contact their own minister. They may wish to go to the chapel or to a prayer room or quiet room, if available. It is not acceptable for Catholic Patients to receive sacraments (i.e. Holy Communion or Anointing) by other Christian denominations. In case of doubt contact the Roman Catholic Chaplain. Patients may wish to see a Chaplain before an operation for prayers and to receive Holy Communion. They may request a Bible (The Gideon New Testament should be available at every bedside locker). Baptisms, Confirmations and Holy Communion may take place on the Wards or in the Hospital Chapel. These will be the Chaplain s responsibility. Marriages in hospital need special consent from managers and legal registration and take place very occasionally; please refer to the Chaplain. If a patient is in any kind of spiritual distress, the Chaplain or an appropriate local minister may be called to offer comfort. DIET 1) Some patients may wish to observe Friday as a no meat day, therefore a fish or vegetarian alternative must be made available. 2) Some patients may wish to fast before receiving Holy Communion, which may have implications for the serving of meals. No period of fasting is required for the sick; their carers are asked to encourage patients to receive Holy Communion when possible, even when they are unable to fast. The elderly, and those who are suffering from some illness, as well as those who care for them, may receive Holy Communion even if within the preceding hour they have consumed something. (See Canon 919.3). CARE OF THE DYING 1) In addition to the normal visits by the Chaplain, The Sacrament of the Sick with anointing is of particular importance. This may also be required before an operation. 2) Inform the priest long before the point of death so that he may build up a relationship with the patient and the family at this stage of the patient s life. 3) The Catholic Priest should be contacted to care for a dying patient or for one who has just died and he will normally be of assistance in consoling the relatives. If the patient has not already been anointed, the Priest may wish to have access to the body in order say appropriate prayers, together with the relatives present. The body should not be removed to the mortuary until after he has had the opportunity to do so. 4) Baptism of infants in danger of death should take place and children, who have been baptised, should be confirmed, if they are in danger of death. 17 The RC Patient is continued overleaf

18 The RC Patient: continued from previous page VIEWING THE BODY - VISITS TO SEE THOSE WHO HAVE DIED Please arrange the place/chapel of rest appropriately; a cross or crucifix may be placed in the chapel; commendatory prayers may be said. POST-MORTEMS AND ORGAN DONATION/TRANSPLANT 1) No religious objection to post-mortem examination: normal legal procedures must be observed, and these should be explained to the next of kin. 2) No religious objection to organ donation: the wishes of the patient and next of kin should be ascertained, and consent obtained. CONTACT No information about a patient should be passed to the contacts without the permission of the patient or next of kin For more general or guidance matters:- Rev Joseph Whisstock BSc (Hons), BA (Hons) Healthcare Advisor Diocese of Brentwood 27 Milton Road Westcliff-on-Sea Essex SS0 7JP The Christian Patient is continued overleaf for Free Church 18

19 THE CHRISTIAN PATIENT FREE CHURCH Church members are from a variety of cultural backgrounds, which affects their spirituality. The Free Churches are:- In the Free Church Federal Council: The Afro-West Indian United Council of The Assemblies of God (A Pentecostal Churches Church) The Congregational Federation The Baptist Union of Great Britain and The Countess of Huntingdon s Connexion The Baptist Union of Wales The Free Church of England The Council of African & Afro-Caribbean churches UK The Methodist Church The Fellowship of Churches of Christ The New Testament Church of God The Independent Methodist Churches The United Reformed Church in the UK The Old Baptist Union The Wesleyan Reform Union The Moravian Church The Presbyterian Church of Wales The Union of Welsh Independents The Salvation Army And also there are Independent Churches and Missions The Church of the Nazarene The Church of Scotland The Christadelphians The Brethren, including The Plymouth Brethren: see separate entry The Church of God The Society of Friends-Quaker: see separate entry Patients may use the terms Chapel or Nonconformist to indicate that they are Free Church The information below is a general guide only. Always check everything with the patient/client. If in doubt, ask them, or the contact, for advice. Free Church patients will welcome prayers and Bible reading; depending upon their tradition they may expect a sacramental ministry, and request Holy Communion or other sacraments. The Free Church Chaplain oversees spiritual care for Free Church patients; ministry may be given by the patient s own church minister or one of the chaplaincy team. They may request a Bible (The Gideon New Testament should be available at every bedside locker), or wish to attend services in the Chapel the times of these should be indicated on every Ward. Holy Communion may take place on the wards or in the hospital chapel. These will be the Chaplain s responsibility. Marriages need special consent from managers and legal registration; they take place very occasionally. If a patient is in any kind of spiritual distress, the local minister or, in hospital, the Chaplain may be called to offer comfort. The Free Church Patient is continued overleaf 19

20 The Free Church Patient: continued from previous page DIET Some patients may wish to fast as a spiritual discipline and some may wish to fast before receiving Holy Communion, which may have implications for the serving of meals. CARE OF THE DYING 1) Depending upon their tradition an appropriate ministry may be expected. Ask the patient/significant others if this is required. 2) Blessing, Baptism or Commendation for infants, who are seriously ill or in danger of death should be offered many Free Church members will choose prayers of blessing and commendation; some of them follow their tradition of thanksgiving or dedication of infants and adult baptism. VIEWING THE BODY - VISITS TO SEE THOSE WHO HAVE DIED Please arrange the place/chapel of rest appropriately; a cross or crucifix may be placed in the chapel; commendatory prayers may be said. POST-MORTEMS AND ORGAN DONATION/TRANSPLANT 1) No religious objection to post-mortem examination: normal legal procedures must be observed, and these should be explained to the next of kin. 2) No religious objection to organ donation: the wishes of the patient and next of kin should be ascertained, and consent obtained. CONTACT No information about a patient should be passed to these contacts without the permission of the patient or next of kin Revd, Christine Pocock Health Care Chaplaincy Board of the Free Church Federal Council c/o Hospital Chaplaincies Council Church House Great Smith Street London SW1P 3NZ For other contacts see Religions in the UK, A Multi-Faith Directory. 20

21 THE CHRISTIAN SCIENTIST PATIENT The information below is a general guide only. Always check everything with the patient/client. If in doubt, ask them, or the contact, for advice. If the patient is voluntarily in hospital, they are likely to accept conventional but minimal medical treatment. They will also ask for drug therapy to be kept to the minimum. If involuntary, i.e. after an accident, they may wish to be completely free of medical treatment. Therefore there will be a need to contact the Christian Science practitioner. Refer to the relatives for the address and record it in the notes, or seek advice from the contact below. No specific objections to blood transfusions, but would prefer to rely on prayer. Therefore they would not usually wish to participate as donor or a recipient. Privacy will be needed for prayer and Bible reading. This should be made available by closing the curtains, or use of a quiet room if available. Children will fall under the Children Act If doctors are considering a Court Order to impose medical treatment, the parents should be informed as early as possible so that they can be represented at Court. DIET No alcohol or tobacco CARE OF THE DYING 1) There are no particular last rites specified by the Faith, but the relatives may request support. 2) Female body to be handled by female staff. 3) Cremation is usually chosen in preference to burial, but it is entirely a matter of family choice. POST-MORTEMS AND ORGAN DONATION/TRANSPLANT 1) Post mortems should be avoided, unless required by law. 2) For post mortems, normal legal procedures must be observed, and these should be explained to the next of kin. 3) Would not normally wish to donate or receive an organ. CONTACT No information about a patient should be passed to the contact without the permission of the patient or NOK. For guidance in care of a patient, contact: 21

22 DIET GYPSIES AND TRAVELLERS: CULTURE AND RELIGIOUS AFFILIATIONS We realise that this group is a different category from the others in this Directory, but feel it is valuable to give information about the Gypsy and Traveller culture. The information below is a general guide only. Always check everything with the patient/client. If in doubt, ask them, or the contact, for advice. The languages spoken are the language of the host country as well as the local Romany dialect. Irish Travellers speak a language called Shelta. There should be no language difficulties deriving from their Roma culture; if they are from abroad, interpreters speaking the language of the country of origin will suffice. The religion followed also depends on the country of origin. Please see entries under relevant religions. There are a number of churches 'adopted' by Gypsies and Travellers: Irish Gypsies will tend to be Roman Catholics, English will use the local Church of England for burials, and there are evangelical Gypsy churches (see Free Church page). Some Gypsies may feel unwelcome in some churches or places of worship The extended family is important. Gypsies and Travellers are very unlikely to go into residential homes for the elderly. In hospital, large numbers of visitors are likely and they may be uninhibited in showing emotion such as grief. It is important to understand this, and to ask for support from the chaplaincy when appropriate. The culture is oral, so written communications should be explained fully and requests should be noted and agreed. There are sensitivities about gender roles, so it may be difficult to accept treatment by the opposite sex. Access to health services is difficult for Travellers. The long history of friction between the sedentary community and Travellers leaves a legacy of mistrust and suspicion. The naming system is important. The surname describes the clan, and family names are often similar. First names also tend to run in families and extended families, so it is important to check (e.g.: by date of birth) and avoid confusion. English Gypsies and Travellers are recognised under law as an ethnic minority and their culture should be respected. Dietary considerations vary according to the religion followed. CARE OF THE DYING 1) Death may not be talked about by some Travellers, but evokes the need to express grief and to organise appropriate rituals. 2) As above, there will be many visitors, and they may be uninhibited about expressing grief. It is appropriate to have several staff available and to make appointments carefully. Gypsies and Travellers continued overleaf 22

23 Gypsies and travellers: continued from previous page 3) If the patient is Christian (Roman Catholic, Church of England, Free Church or Orthodox) a priest or minister must be called to commend the patient to God and console the bereaved. See appropriate page for contacts. 4) For members of other religions, please see relevant pages in this directory. 5) There are often specific and elaborate funeral rites. A fire has to burn between death and the funeral, and this fire is attended by family members. 6) When on the road, the deceased person's possessions had to be burned, but this practice is not often followed now. POST-MORTEMS AND ORGAN DONATION/TRANSPLANT 1) Gypsies and travellers will be reluctant to allow post-mortem, but normal legal procedures must be observed, and these should be explained to the next of kin. 2) For organ donation, the wishes of the patient and next of kin should be ascertained, and consent obtained. CONTACT No information about a patient should be passed to the contact without the permission of the patient or next of kin. 23

24 THE HINDU PATIENT DIET The information below is a general guide only. Always check everything with the patient/client. If in doubt, ask them, or the contact, for advice. Female patients prefer female doctors and consideration should be given to their modesty. Ask the pregnant woman if there are any special birth rites to be observed. Running water or a jug of water in the same room as the toilet is required; if a bedpan is used a bowl of water must be offered afterwards. Ablutions are important. Avoid using the left hand unnecessarily with patients. This hand is regarded as unclean. Offer a volume of the Bhagavad-Gita, which can be obtained from the faith community or refer to the Chaplain. The patient may wish to lie on the floor (close to Mother Earth) The family may wish to stay with the patient all the time. 1) Many are vegetarians but some do not eat eggs, therefore explanation of the content of unfamiliar food would be welcomed. Beef should never be served. 2) There is a dislike for plates which have been used for non-vegetarian food. A coloured plate system would be appreciated or disposable plates. 3) There will be the need to rinse the mouth after eating. CARE OF THE DYING (LAST RITES PUJA) If death is imminent, Hindu patients wherever possible would like to die at home. Death in hospital can be distressing for the relatives. 1) Before death there will be a desire to distribute food and one s own articles of use to the needy, religious persons and the Temple. These gifts will be brought by the relatives for the patient to touch, before giving away. 2) A Hindu would like to have the leaves of the sacred Tulsi plant and Ganges water placed in his/her mouth by relatives before death. Therefore warn the relatives if death is imminent. 3) After death the wishes of the dead are honoured. 4) Consult the family if they wish to perform the Last Rites in the hospital. The body has to be bathed in water mixed with water from the River Ganges. Normally this is done at home by the family. 5) Do not remove sacred signs like threads or jewellery from the dead body. 6) Consult the wishes of the family before touching the body. The use of gloves would be appreciated. 7) Viewing of the body: a) Remove all religious symbols b) Place OM, if available, on the altar or shelf. c) Allow the head of the patient to be close to the OM. 8) A Hindu is cremated. It is preferred that no longer than 24 hours lapses before the funeral. 24

25 The Hindu Patient: continued from previous page POST-MORTEMS AND ORGAN DONATION/TRANSPLANT 1) Post mortems are not liked, but if required by law, all organs and remains must be returned before the funeral. Normal legal procedures must be observed, and these should be explained to the next of kin. 2) There is no religious objection to transplants. The wishes of the patient and next of kin should be ascertained, and consent obtained. CONTACT No information about a patient should be passed to the contact without the permission of the patient or next of kin Pandit Dharmesh Chandra Mishra 43 Cleveland Road Ilford Essex IG1 1EE dharmeshcander@yahoo.co.uk. 25

26 THE HUMANIST PATIENT DIET The information below is a general guide only. Always check everything with the patient/client. If in doubt, ask them, or the contact, for advice. Humanists believe strongly in the individual s right to freedom of choice in the main decisions of life and death, and this will, therefore, have a bearing on discussions about a patient s prognosis. All people are equal regardless of sex, culture, age, race or sexuality and must endeavour to find solutions for problems within themselves. They do not believe in any god or life after death No special needs but a higher proportion are vegetarian/vegan than in the population as a whole. CARE OF THE DYING 1) No praying please 2) Remove or cover religious signs if body is to be viewed 3) When dealing with a funeral director after the patient has died, he should be informed that a non-religious service will be required. There are trained Humanist officiates for funerals (see contacts below) POST-MORTEMS AND ORGAN DONATION/TRANSPLANT 1) No objection on Humanist grounds. 2) For post mortems normal legal procedures must be observed, and these should be explained to the next of kin. 3) For organ donation, the wishes of the patient and next of kin should be ascertained, and consent obtained. CONTACT Denis Cobell For hospital visits, by appointment. Baby naming, weddings or funerals may be requested by the patient or next of kin. Weddings in hospital must be referred to the Trust Management. No information about a patient should be passed to the contact without the permission of the patient or next of kin. 26

27 THE JAIN PATIENT DIET The information below is a general guide only. Always check everything with the patient/client. If in doubt, ask them, or the contact, for advice. Female patients will usually prefer a female doctor and nurse and considerations should be given to their modesty and this desire. The Jain patient may wish to say prayers with their Brahman. 1) All Jains are vegetarians. 2) Some Jains may refuse potatoes, garlic and onions with their meal; so it is important to ask the patient what is acceptable food for them. 3) Many Jains prefer not to eat after sunset. CARE OF THE DYING 1) The family may provide a plain white gown or shroud for the dead patient. 2) The family may wish to be present during the last offices and also to assist in their administration, and should, therefore, be asked if they wish to do so. POST-MORTEMS AND ORGAN DONATION/TRANSPLANT 1) Post-mortem is usually seen as disrespectful to the body, but this will depend on the orthodoxy of the patient. If required by law, normal legal procedures must be observed, and these should be explained to the next of kin. 2) Jains may be willing to both give and receive organs. The wishes of the patient and next of kin should be ascertained, and consent obtained. CONTACT No information about a patient should be passed to the contact without the permission of the patient or next of kin. 27